The Effectiveness of Multicultural
Running head: THE EFFECTIVENESS OF MULTICULTURAL COUNSELING
The Effectiveness of Multicultural Counseling Competencies vs. Universal Systems of
Counseling
CED 5910-Introduction to Counseling and Human Services
Kean University
Dashua U. Hinton
Spring 2010
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The Effectiveness of Multicultural
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The Effectiveness of Multicultural Counseling Competencies vs. Universal Systems of
Counseling
One major principle for culturally effective counseling and psychotherapy is recognizing
one’s own self awareness through examination of cultural values, biases, and a thorough
understanding of other cultures. Currently, many upcoming mental health professionals are
becoming more cognizant of multicultural issues and recognize the impact of effective treatment
for multi-ethnic populations. Many colleges and universities nationwide have incorporated
cultural competency and multicultural counseling curriculums into their programs as an effort to
build cross-cultural counseling skills and familiarize students with theories, counseling
techniques, skill development and a wide range of issues regarding ethical and effective
counseling in a world of cultural differences. Such emphasis are also placed on expanding
cultural awareness, knowledge, and skill building in order to facilitate an appreciation of cultural,
racial, ethnic, age, gender and sexual preference issues.
For present day mental health professionals, it is essential to understand one’s own
cultural heritage and awareness before going forward in understanding and assisting individuals
in treatment. As a result of the growing need for promoting culturally competent practitioners,
multicultural counseling competencies were evolved and developed so that many mental health
professionals could provide optimal care to clients of different backgrounds. This is extremely
important as counselors incorporate a greater awareness of their clients' culture into their theory
and practice. Yet, some professionals in the field argue that the need for such multicultural
competencies are irrelevant to the counseling profession and despite the growing microcosm of
this present culture, there is no specific form of counseling that is multicultural. Some also argue
that all counseling is multicultural which would negate the effectiveness of multicultural
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competencies within the counseling profession. As a result, this research paper seeks to examine
the Effectiveness of Multicultural Counseling Competencies in contrast to universal methods and
approaches that are effective and used with all kinds of clients. In addition, this literature review
also seeks to examine counseling approaches that will ultimately lead to better outcomes for
multi-ethnic clients in counseling, in particular African Americans.
Sue (2003) suggests the following:
Multicultural counseling and therapy in relation to the therapy process and the roles of
the mental health practitioner may be defined as both a helping role process that uses
modalities and defines goals consistent with the life experiences and cultural values of
clients, recognizes client identities to include individual group, and universal
dimensions, advocates the use of universal and culture specific strategies and roles in
the healing process, and balances the importance of individualism and collectivism in
the assessment, diagnosis, and treatment of client and client systems. (p.16)
One may inquire of the effectiveness of multi-cultural counseling, and how it helps in
facilitation of building a therapeutic alliance between counselor and client. In order to understand
the importance of multi-cultural counseling, one must also acknowledge the importance of mutlicultural competence. Sue ( 2003) defines multicultural counseling competence as the
“counselor’s acquisition of awareness, knowledge, and skills needed to function effectively in a
pluralistic democratic society and on a organizational/societal level advocating effectively to
develop new theories, practices, policies, and organizational structures that are more responsive
to all groups” Therefore, it is key for any mental health professional to identify and become fully
aware of the importance of multicultural counseling and cultural competency in their practice.
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However; despite how important multicultural counseling is to the counseling profession,
some still argue against it. Patterson (2004) suggests that there is no specific form of counseling
that is multicultural. All counseling is multicultural; everyone lives in a multicultural society.
But this does not mean that mental health professionals need different counseling theories and
practice for all the possible groups in that society. Patterson goes on to state that no mental health
counselor however; can be prepared to counsel every possible client. The mental health
practitioners prepared under the universal system will have the bases of becoming capable of
counseling a wide variety of client. Such mental health counselors will, of course need special
preparation to work with clients from particular groups.
Patterson explains the universal system of counseling as what is known as client-centered
therapy. There are five basic qualities in this system which includes respect for the client,
genuineness, empathic understanding, and communication of empathy, respect, and genuineness
to the client and structuring. (Rogers, 1957) These professional qualities are not only essential
for effective counseling, however; it also serves as the elements of all facilitative interpersonal
relations. They are neither time bound nor culture bound. Patterson also goes on to explore two
faulty assumptions which describe multicultural competencies as lacking philosophical
foundations. The first faulty assumption is that counseling or psychotherapy is a matter in
information, knowledge, practices, skills, or techniques. The second faulty assumptions is that
client differences are more important than client similarities that it is useful and desirable to
classify clients into a number of discrete groups, each requiring different counseling treatments.
Adherence to a specific counseling theory or method may also limit the success of
counseling. Many cultural groups do not share the values implied by the methods and thus do not
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share the counselor's expectations for the conduct or outcome of the counseling session. To
counter these differences, effective counselors must investigate their clients' cultural background
and be open to flexible definitions of "appropriate" or "correct" behavior. (LaFromboise, 1985)
Overall Patterson points out that review of recommendations and suggestions for specific
methods and techniques or skills for working with multicultural clients indicate that there is no
evidence for the appropriateness or effectiveness of these methods. “It follows that we do not
need competencies for multicultural clients. We need methods and approaches that are effective
with all kinds of clients. These methods would constitute a universal system of counseling.”
(Patterson, 2004)
In April 1991, the Association for Multicultural Counseling and Development (AMCD)
approved a document outlining the need and rationale for a multicultural perspective in
counseling. The work of the Professional Standards committee went much further in proposing
31 multicultural counseling competencies and strongly encouraged the American Association for
Counseling and Development (AACD), and the counseling profession to adopt these
competencies in accreditation criteria. The hope was to have the competencies eventually
become a standard for curriculum reform and training of helping professionals. As a result, The
American Association of Multicultural Counseling and Development created the (AMCD)Multicultural Counseling Competencies in order to promote counselor awareness of their own
cultural values and biases, the client’s worldview, and culturally appropriate intervention
strategies. This was also a result of many organizations noting the serious lack of training
programs in addressing racial, ethnic, and cultural matters.
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In the past, society has operated primarily within a monoculture and monolingual
perspective reflected in what has been referred to as the “encapsulated counselor” (Wrenn,
1962). Fast forwarding to this present day, multiculturalism is an explosive phenomenon. The
American culture is no longer viewed as a diverse melting pot but more closely related to a salad
bowl society consisting of hundreds of languages and dialects spoken daily in this country. With
mental health issues on the rise, it can be observed that there is a rational and fundamental need
for a multicultural perspective and cross cultural counseling approach to meet the needs of
various populations. One particular at risk population includes the African American race and
disparities in mental health care for this population. The effectiveness of multicultural
competencies can have a huge impact on the risk factors associated with the African American
race.
One risk factor affecting the African American race is examined by Tucker and Dixon
(2009). Their research explored current challenges facing impoverished African American male
youth who exhibit symptoms of attention deficit hyperactivity disorder, the need for mental
health services, and the barriers to services that they face, and offer recommendations for mental
health counselor. Many mental health professionals must be equipped with specific tools and
strategies for working with at risk populations who experience barriers to mental health services.
Further research suggests that African American males are overrepresented in most categories of
learning, emotional, and behavioral disabilities. The Office of Special Education Programs, 2005
includes in their studies that African American children were overrepresented in specific learning
disabilities (18%), mental retardation (34%) and emotional disturbance categories (28%).
In addition to the alarming rates of African American children overrepresentation of
disabilities, there are also disparities in the mental health care for African Americans. As a result,
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“Tucker and Dixon (2009) concludes that African American boys have much higher reported
rates of problem behaviors that do Euro American boys but are far less likely to receive a
diagnosis of ADHD. In conjunction to the disparities faced within the African American race in
mental heath are also concerns of cultural stigma surrounding mental health care regarding
discrimination and the perception and views that mental health professions have of their multiethnic clients. Tucker and Dixon (2009) also suggest that in order to effectively reach African
American families, counselors should draw from literature to inform their practices for engaging
families, engage families in a mutual sharing model of communication instead of traditional oneway, counselor as expect model. Mental health counselors should also be aware of class bias in
their approach and should explain all mental health issues to their clients. Overall, many
counselors can improve the effectiveness of counseling African Americans by becoming more
conscious of the issues involved in the assessment, diagnosis, and treatment of ADHD by
systematically learning and incorporating methods of reaching at risk clients and addressing
barriers and injustices of their clients.
The need for culturally responsive treatments has become more urgent as the number of
ethnic minority clients increase, as a result, Previous research of a clinically referred sample of
substance abusing African American inner city teenagers found that treatment engagement
increased when cultural content was incorporated in the therapeutic process. Liddle, Gilfort, and
Marvel (2006) suggest that clinical outcomes may be improved by integrating culturally
responsive intervention methods within a multisystemic approach to treatment. It is believed that
clinical outcomes can be enhanced by responding to the cultural, environmental, relational, and
interpersonal contexts of the adolescent’s life. Research has also shown that culturally responsive
therapeutic services enhance clinical outcomes for African Americans.
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Because of the vital need to enhance the effectiveness of mental health services for racial and
ethnic groups, numerous studies have been conducted evaluating culturally adapted
interventions. Griner and Smith (2006) conducted a study using metaanalyytic methodology to
summarize data. As a result, the study indicated a moderately strong benefit of culturally adapted
interventions. Interventions targeted to a specific cultural group were four times more effective
than interventions provided to groups consisting of clients from a variety of cultural
backgrounds. Overall, the findings were indicative of providing evidence that the benefits of
culturally adapting mental health interventions particularly when the interventions are targeted to
a specific racial ethnic group and when the interventions are conducted in client’s preferred
language.(Griner & Smith, 2006)
Constatine (2007) examined the relationship among African American client’s perceptions
of their white counselors with respect to perceived racial microaggressions in cross racial
counseling relationships, the counseling working alliance, the counselors’ general and
multicultural counseling competence and their counseling satisfaction. As a result, studies
indicated that perceived racial microaggressions were negatively associated with African
American client’s perceptions of the therapeutic working alliance with the white therapist
general and multicultural counseling competence. Results also indicated that African American
clients who perceived a less effective therapeutic working alliance with white counselors were
more likely to perceive these counselors as having lower levels of both general and multicultural
counseling competence. Furthermore, findings reveal that African American clients perceived
racial microaggressions had an indirect effect on both general and multicultural counseling
through these clients’ perceptions of the therapeutic working alliance. Findings also indicated
that African Americans client’s perceptions of white counselors’ general and multicultural
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counseling competence were not significantly associated with the clients counseling satisfaction
ratings nor did they significantly mediate the relationship between the therapeutic working
alliance, counseling satisfaction ratings, and perceived racial microaggressions and counseling
satisfaction.
Numerous researchers have attempted to generate counseling services to improve
therapeutic outcomes for people of color in counseling and psychotherapy. Unfortunately, in
some cases, therapeutic approaches do not reflect sensitivity to such populations resulting in
ineffective services and negative attitudes towards the profession and those associated with the
profession. However; in order for effective strategies to be implemented successfully and
improved for Mental health practitioner must be willing to become more aware of multicultural
issues and the need to improve the quality of mental health services.
It is a sad occasion that despite the many milestones that this country has made in
enforcing equal rights for many, that certain ethnic groups experience inequities in the mental
health system. Despite the increase in multi cultural research, African Americans and other
clients of color are still not fearing well with counseling services, In addition, there continues to
be a need to address how effective multi cultural counseling approaches are for African
Americans and other clients of color, it is also important to address multicultural issues in cross
counseling relationships. Therefore, multicultural competencies are encouraged for treatment in
working with people of color. As a result of this literature review, studies have shown and
support that multicultural counseling and therapy provides a framework and a theoretical basis
which supports positive outcomes in treatment for people of color. Studies have also shown that
cultural competencies are not needed in the profession of counseling and that counseling should
take on the universal role. Although counseling can be considered universal, it is firmly
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supported that the role of clinicians and mental health practitioners from diverse backgrounds
despite their similarities and differences in clinical approaches should become more responsive
and culturally aware as they provide services to diverse clients. Overall, there is a need for the
rationale and need for a multicultural perspective in counseling, and for those in the field,
multicultural counseling in the profession should be considered necessary for ethical practice as
a counseling profession.
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References
Constatine, M. G. (2007). Racial Microaggression Against African American Clients in CrossRacial Counseling Relationships. Journal of Counseling Psychology, 54(1), 1-16.
Griner, D., & Smith, T. B. (2006). Culturally Adapted Mental Health Interventions: A MetaAnalytic Review. Psychotherapy: Theory, Research, Practice, Training, 43(4), 531-548.
Lafromboise, T.D. (1985). The Role of Cultural Diversity in Counseling Psychology. The
Counseling Psychologist, 13, 649-655.
Liddle, H., Gilfort, A. J., & Marvel, F. A. (2006). American Journal of Orthopsychiatry. An
Empirically Supported and Culturally Specific Engagement and Intervention Strategy for
African American Adolescent Males, 75(2), 215-225.
Marbley, A. F., et al. (2007). Real Cases with African American Clients: Reports of Racially
Diverse Practitioners. Journal of Humanistic Counseling, Education And Development,
46.
Office of Special Education (2005). Twenty-fifth annual report to Congress on Special
Education Programs. Retrieved from
http://www.ed.gov/about/reports/annual/osep/2003/25th-vol-1sec-2.pdf
Patterson, C. H. (2004). Do We Need Multicultural Counseling Competencies? Journal of
Mental Health Counseling, 26(1), 67-73.
Rogers, C. R. (1957). The necessary and sufficient conditions of therapeutic personality change.
Journal of Consulting Psychology, 21, 95-103.
Sue, D. W., Arrendondo, P., & McDavis, R. (1992). Multicultural Counseling Competencies and
Standards: A Call to the Profession. Journal of Counseling & Development, 70.
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Sue, D. W., & Sue, D. (Eds.). (2003). Counseling the Culturally Diverse (4th ed., Rev.). Canada:
John Wiley & Sons.
Tucker, C., & Dixon, A. L. (2009). Low-income African American Male Youth with ADHD
Symptoms in the Unites States: Recommendations for Clinical Mental Health
Counselors. Journal of Mental Health Counseling, 31(4), 309-322.
Wrenn, C. G. (1962). The culturally encapsulated counselor. Harvard Education Review, 32,
444-449.